University Hospitals Kingston Foundation

You can make a donation in honour of any hospital staff member who made a difference in your care. They will receive an acknowledgement letter informing them of your gift (amount will not be disclosed) and a certificate that may be displayed in their office, waiting room or home.

Donation Information

Amount:

A gift of

$ 25.00

A gift of

$ 50.00

A gift of

$ 75.00

A gift of

$ 100.00

Other (min. $10)

$

*

Designation:

Other designation not listed above

*

Additional Information

Type of gift:

One-time giftRecurring gift

Frequency:

On:

Starting:Ending:Ending:

I prefer to make this donation anonymously:

Please do not inform the person of my name.

Personal Message to Caregiver(s):

Donor Information

Title:

*

First name:

*

Last name:

*

Country:

*

Address lines:

*

City:

*

Province:

*

Postal Code:

*

Phone:

Email:

*

Payment Information

Payment Method:

Credit CardDirect Debit

Cardholder's Name:

*

Credit Card Number:

*

Card Type:

*

Card Expiry:

/

*

Card Security Code:

*

Caregiver(s) Information

Please enter information about the person/department in which you are making a gift in honour of. Your information will be asked on the following page.